Implementation of Community Education for the Prevention of Colorectal Cancer.

Posted: December 19th, 2022

Implementation of Community Education for the Prevention of Colorectal Cancer.

 

Evidence-Based Capstone Project on the Implementation of Community Education for the Prevention of Colorectal Cancer (CRC), Reducing its Rates, and Increasing its Screening Among the Hispanic and Latina Communities in the United States  .Implementation of Community Education for the Prevention of Colorectal Cancer.

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            Colorectal cancer is one of the leading causes of death in the United States. It is a form of cancer that affects the cells of the rectum and the colon. These cells undergo mutations and grow out of control, with the body’s normal immune control becoming unable to control the growth (Hammer & McPhee, 2018; Huether & McCance, 2017). All population demographics in the United States are affected by colorectal cancer. However, the Hispanic/ Latino community has been found to be more disproportionately affected by this cancer than the other communities. On closer examination, it is clear that the problem that makes this community more vulnerable to colorectal cancer than other communities is related to their low socio-economic status, low education levels, and insufficient healthcare coverage (Martinsen et al., 2016). The identified problem is therefore what the best intervention could be to increase both the knowledge about colorectal cancer and its screening among the members of the Hispanic community.Implementation of Community Education for the Prevention of Colorectal Cancer. Research evidence done reveals that the best approach or solution is the provision of education about colorectal cancer (about its causes, screening, and prevention) at the community level (Briant et al., 2018; Brenner et al., 2016; Cruz-Correa et al., 2016). This paper is about the project implementation plan of this project that aims at applying the solution identified through evidence search (community education for increasing colorectal cancer knowledge and screening among Hispanics).Implementation of Community Education for the Prevention of Colorectal Cancer.

The Need for Project Management

For any project to succeed without any delays and hitches there is always a need for project management. Project management is the process of ensuring that everything that is required for a project to be completed is in place and that the time and resources available are sufficient for the project to be completed successfully. Project management goes through several distinct phases that are namely (Villanova University, 2019):

1. Project initiation
2. Project planning
3. Project execution
4. Project monitoring and control, and
5. Project evaluation and closure

The initiation of this particular capstone project started with the identification of the problem which was determined to be the rampant and disproportionate presence of colorectal cancer among the Hispanic people in the United States. A search for a possible solution to this problem was then done. The search for a solution was then conducted through a search for evidence, as the intended solution or intervention must be evidence-based. Enough of the evidence collected showed that education would be the most effective intervention to tackle the problem of high prevalence of colorectal cancer among Hispanics. All this happened during the project initiation phase of this capstone project. A feasibility study was conducted on the implementation timeline, goals, and costs and all were found to be feasible.Implementation of Community Education for the Prevention of Colorectal Cancer.

The project planning phase of this capstone project is what this paper is about. A project plan should give an indication of the enormity of the project and what is to be expected when the implementation of the project gets underway. In this case, this project plan identifies the clinical site where this implementation will be taking place. The project plan of this project also assesses the readiness of the target entity for change, change awareness, change agility, change reaction, and change mechanisms. The other thing that happens during this project planning phase is the obtaining of the required approvals for the carrying out of this project. This notably comes from the Institutional Review Board or IRB (the institution that is tasked with regulating research and interventions involving human subjects, to ensure that bioethical principles are upheld during the project). Lastly, this project plan also includes a situational SWOT analysis of the project to identify its potential strengths, weaknesses, opportunities, and threats.Implementation of Community Education for the Prevention of Colorectal Cancer.

The third phase of this capstone project will be project execution. This is where the actual implementation of the suggested solution of education about colorectal cancer will take place at a gastroenterology clinic in Brandon, Florida. It is acknowledged here that the success of the implementation will largely depend on the effectiveness of this planning phase. The fourth stage will be monitoring and control while the fifth will be project evaluation and closure. Monitoring and control will mean that there is close assessment of whether the right education about colorectal cancer is given to the target community. The capstone project will then be closed after ascertaining that the project goals have been achieved as per the timeframe.Implementation of Community Education for the Prevention of Colorectal Cancer.

Organizational Readiness for Change

The identified organization that will act as a catchment center for the targeted Hispanics is a large gastroenterology clinic that is found in Brandon, Florida. The organization was found to be primed for change and selected because it has a large number of Hispanics as its patients. It was determined that the organization has enough awareness that change is needed, by the fact that they were also alarmed by the large numbers of colorectal cancer cases among Hispanics. An interview with the organizational leadership revealed that they also want to improve patient outcomes and therefore the intervention would potentially be beneficial to them. The interview with the medical director at the center also revealed that the organization would support this effort with its own resources if required to. There was a subsequent meeting by the nurse practitioners, nurse managers, and registered nurses at the center. All the healthcare workers at the center resolved to effectively manage both patient and staff reactions to the impending change. Lastly but not least, the center’s medical director assured the project manager of this capstone project that they would adopt and implement this intervention into their organizational culture and practice guidelines if it showed promise and effectiveness.Implementation of Community Education for the Prevention of Colorectal Cancer.

Organizational Approval Process

The approval for this project is needed from the medical director of the gastroenterology center. Before the interview with the director, a formal request had already been made to the effect that it was wished that the project implementation takes place at the center. The center director has already graciously agreed to this request. No other approval is required as far as the organization is required. The only pending approval is that from the federal IRB for the intervention to continue.

Risk Management Assessment

Just like for every project, there is a pressing need for there to be a risk assessment for this capstone project. This is achieved through the SWOT paradigm. Risk assessment enables the identification potential internal weaknesses and external threats that can then be dealt with before project implementation. It also equally enables the identification of internal strengths and external opportunities which can be built on to ensure the success of the capstone project. The SWOT analysis results of this capstone project are as follows:

Strengths

            The identified intervention is specific and the identified population of interest is also well defined.

Weakness

The solution will be implemented at a single point (the gastroenterology center) as opposed to a wider area within the community (door-to-door). This may reduce the effectiveness of the intervention but is inevitable because implementation in the whole Hispanic community of the area would be too costly.Implementation of Community Education for the Prevention of Colorectal Cancer.

Opportunities

Other organizations like the gastroenterology center in Brandon may also be interested in this kind of project and therefore provide funding for a wider community-wide large-scale version of this teaching project.

Threats

            The only notable threat at present is apathy from the community coupled with a carefree attitude (lack of seriousness on disease prevention matters). This will be mitigated by using educators (student nurses) that are fluent Spanish speakers and preferably Hispanic themselves.

Project Plan

            This project plan includes the following:

Planned setting: A busy gastroenterology center for private practice in Brandon, Florida.

Planned participants: These will be the Hispanic patients seen and treated for CRC at the gastroenterology center.

Planned implementation steps: These will encompass (i) recruitment of the patients and their relatives, (ii) obtaining of consent, (iii) introduction of the subject, (iv) delivery of the education, (v) feedback from the patient, and (vi) evaluation of the process.Implementation of Community Education for the Prevention of Colorectal Cancer.

Planned goals: The goals are to achieve education on causes of CRC, to achieve education on the prevention of CRC, and to achieve education on the importance of screening for CRC.

Planned measurable outcomes: (i) knowledge of CRC and (ii) awareness of the presence of screening for CRC.

Plan for Project Evaluation

Project evaluation is important in determining whether the project objectives were achieved or not. In this case, evaluation will involve performing a cross-sectional survey with a questionnaire instrument after six months to determine if the education had been effective.

Plan for demographic data:  Will be determined by the center’s patient records.

Plan for outcome data: Will be compiled in real-time during intervention.

Plan for data management: This will be by way of descriptive statistics – means, standard deviations, charts, and graphs.

Summary

The identified problem for this capstone project is a disproportionately high prevalence of colorectal cancer among the Hispanic people in the United States. The best evidence-based solution to the problem has been found to be education of the Hispanic community on the causes of CRC, its prevention, and the benefits of screening for CRC. Implementation of the capstone project is to be undertaken through a formal project management approach, complete with all the five phases of project management. Project initiation phase is complete and currently the project is in the planning phase. The remaining phases are project execution, project monitoring and control, and project evaluation and closure. Implementation of the project will take place at a focal point, identified as a gastroenterology center in Brandon, Florida. Approval from the management of the center for the project has already been granted. The only pending approval is from the IRB.Implementation of Community Education for the Prevention of Colorectal Cancer.

 

 

APPENDIX I

IRB (Institutional Review Board) Proposal

This is to propose that the attached capstone project plan be approved by the Institutional Review Board (IRB) as safe to be carried out. This approval is to be based on the following:

Project description

This is an academic post-graduate (master’s level) capstone project aimed at implementing the evidence-based intervention of education for the Hispanic community in Brandon, Florida. The education is about the causes of colorectal cancer, its prevention, and the importance of going for screening for the same as a high risk population.

Participants

The project participants will be Hispanic patients suffering from colorectal cancer treated at the gastroenterology center in Brandon in the state of Florida.

Setting

The project setting will be a private practice gastroenterology center in the state of Florida.

Evaluation

Evaluation of the project will be done six months after completion through a cross-sectional survey by way of a questionnaire.

Implementation of Community Education for the Prevention of Colorectal Cancer (CRC),Reducing its Rates, and Increasing its Screening Among Hispnaics

According to the estimates provided by WHO, in the year 2017, adults diagnosed with Colorectal Cancer (CRC) were 130,000; those who died were 50,000 (Briant et al., 2018). Among other cancers affecting adults, CRC 3rd most common in the US and the 2nd most commonly diagnosed among Hispanic adults. According to Brenner et al. (2016), the US has witnessed a gradual decline in the incidences and mortalities of CRC since the 1980s, and this is attributed to the removal of rectal polyps, increased screening rates, and behavior modification, which address potential risk factors. However, this decline is not evident in all US adults.

Existing research suggests that Hispanics are at a higher risk of CRC-related mortality and morbidity due to lower education levels, high rates of poverty, being uninsured, and not being able to access healthcare services (Jackson et al., 2016). These disparities are evident in the rates of CRC and screening rates. To address this issue, research suggests that health education programs to improve screening and create awareness are the most effective approach for prevention and improved health outcomes.

In the United States, CRC affects close to 5% of the general population. For instance, in the year 2016, there were up to 135,000 new cases (Briant et al., 2018). Besides, it is notably the primary cause of mortalities among Hispanics in the US, where every three Hispanic women and men are diagnosed in the life course. Among deaths secondary to cancers, it is the 2nd and the third that causes mortalities among adults of Hispanic origin (Barzi et al., 2017).  Hispanics make up 45% of the population where our facility is located and have high mortality and incidence rates compared to whites.Implementation of Community Education for the Prevention of Colorectal Cancer.

Screening for CRC is vital for early detection and diagnosis since it also increases the survival rates. Although Hispanics are less likely to undergo screening for CRC, it is necessary to identify reasons that lead to very low screening rates in this population. According to a 2017 report by the ACS (American Cancer Society), mortality is reducing at a slower rate among Hispanics in comparison to Blacks and Whites (Barzi et al., 2017). Diagnosis in the late stages and lower screening rates are significant contributors to disparities in mortality.

CRC is treatable and preventable. However, in the advanced form, its prognosis is very poor. Therefore, early diagnosis and detection increase treatment success and survival outcomes. Underutilization of screening plays a significant role in staging and diagnosis of CRC, where the unscreened are at a higher risk of diagnosis in the advanced stages (Martinsen et al., 2016). Similar to the inequity rates of CRC, disparities in the rates of CRC screening and adherence to screening guidelines contribute to high incidences of CRC among Hispanics. This has been attributed to geography, ethnicity, and socioeconomic status. As supported by Shokar et al. (2015), there are more barriers for rural-dwelling Hispanics, such as long-distance traveling in search of care, inability to access PCPs and specialists, uninsured people. Those with a lower income and lower education levels will rarely follow the screening guidelines for CRC. The purpose of this paper paperis to implement community-based targeted colorectal cancer education and screening among Hispanics.Implementation of Community Education for the Prevention of Colorectal Cancer.

The Need for Project Management

For any project to succeed without any delays there is always a need for project management. This capstone project planning is informed by this very same need. Project management is the process of ensuring that the required information and research evidence for a project to be completed is in place and that the time and resources available are sufficient for the project to be completed successfully. Project management goes through several distinct phases that are namely (Villanova University, 2019):

1. Project initiation
2. Project planning
3. Project execution
4. Project monitoring and control, and
5. Project evaluation and closure

The initiation of this particular capstone project started with the identification of the problem which was determined to be the rampant and disproportionate presence of colorectal cancer among the Hispanic people in the United States. This was followed by the search for a possible solution to this problem. The search for a solution was then conducted through a search for evidence, as the intended solution or intervention must be evidence-based. The evidence obtainedthen pointed at education as being the most effective intervention to tackle the problem of high prevalence of colorectal cancer among Hispanics.Implementation of Community Education for the Prevention of Colorectal Cancer.

A good project plan gives an indication of the enormity of the project and what is to be expected when the implementation of the project gets underway. In this case, this project plan identifies the clinical site where this implementation will be taking place. It also assesses the readiness of the target entity for change, change awareness, change agility, change reaction, and change mechanisms. The planning phase also requires obtaining of the required approvals for the carrying out of the project. Lastly, this project plan also includes a situational SWOT analysis of the project to identify its potential strengths, weaknesses, opportunities, and threats.Implementation of Community Education for the Prevention of Colorectal Cancer.

The third phase of this capstone project will be project execution. This is where the actual implementation of the suggested solution of education about colorectal cancer will take place at a gastroenterology clinic in Brandon, Florida. It is acknowledged here that the success of the implementation will largely depend on the effectiveness of this planning phase. The fourth stage will be monitoring and control while the fifth will be project evaluation and closure. Monitoring and control will mean that there is close assessment of whether the right education about colorectal cancer is given to the target community. The capstone project will then be closed after ascertaining that the project goals have been achieved as per the timeframe.Implementation of Community Education for the Prevention of Colorectal Cancer.

Organizational Readiness for Change

The identified organization that will act as a catchment center for the targeted Hispanics is a large gastroenterology clinic that is found in Brandon, Florida. The organization was found to be primed for change and selected because it has a large number of Hispanics as its patients. It was determined that the organization has awareness that change is needed, based on data collected from the previous year of Hispanics being diagnosed with colorectal cancer at a later age and from feedback from patients stating the lack of understanding for the need of colorectal cancer screening.Implementation of Community Education for the Prevention of Colorectal Cancer. An interview with the decision makers at the organization revealed that they also want to improve patient outcomes and therefore the intervention would potentially be beneficial. The interview with the medical director at the center also revealed that the organization would support this effort with its own resources if required to.Implementation of Community Education for the Prevention of Colorectal Cancer. There was a subsequent meeting by the nurse practitioners, nurse managers, and registered nurses at the center. They all resolved to effectively manage both patient and staff reactions to the impending change. Lastly, the center’s medical director assured the project manager of this capstone project that one would adopt and implement this intervention into their organizational culture and practice guidelines if it showed promise and effectiveness.

Organizational Approval Process

The approval for this project has been obtained from the medical director of the gastroenterology center. Before the interview with him, a formal request had already been made to the effect that it was wished that the project implementation is to take place at the center. The center director has already graciously agreed to this request.Implementation of Community Education for the Prevention of Colorectal Cancer.

Risk Management Assessment

There is a pressing need for there to be a risk assessment for this capstone project. This is achieved through the SWOT analysis. The SWOT analysis is an effective approach in identifying the strengths and weaknesses, and the opportunities and threats. However, the tools used in developing a complete and precise understanding so that the analysis lends itself to an effective improvement initiative will have to be consistent with the nature of the improvements. Typically, the weaknesses will require that the existing practices are carried out more efficiently. These areas would need to be seen in a process or performance improvement framework. The threats on the other hand, carry more strategic implications and may require a very careful assessment.Implementation of Community Education for the Prevention of Colorectal Cancer.

Nonethless, Risk assessment enables the identification potential internal weaknesses and external threats that can then be dealt with before project implementation. It also equally enables the identification of internal strengths and external opportunities which can be built on to ensure the success of the capstone project. The SWOT analysis results of this capstone project are as follows:Implementation of Community Education for the Prevention of Colorectal Cancer.

Strengths

            The identified intervention is specific and the identified population of interest is also well defined.

Weakness

The solution will be implemented at a single point (the gastroenterology center) as opposed to a wider area within the community (door-to-door). This may reduce the effectiveness of the intervention but is inevitable because of cost considerations.

Opportunities

Other organizations like the gastroenterology center in Brandon may also be interested in this kind of project and therefore provide funding for a wider community-wide large-scale education project.

Threats

            The only notable threat at present is apathy from the community coupled with indifference. This will be mitigated by using educators (student nurses) that are fluent Spanish speakers and preferably Hispanic themselves.

Summary

The identified problem for this capstone project is a disproportionately high prevalence of colorectal cancer among the Hispanic people in the United States. The evidence-based solution to the problem includes to provide education of the Hispanic community on the causes of CRC, its prevention, and the benefits of screening for CRC. Implementation of the capstone project is to be undertaken through a formal project management approach, complete with all the five phases of project management. Project initiation phase is complete and currently the project is in the planning phase. The remaining phases are project execution, project monitoring and control, and project evaluation and closure. Implementation of the project will take place at a focal point, identified as a gastroenterology center in Brandon, Florida. Approval from the management of the center for the project has already been granted.Implementation of Community Education for the Prevention of Colorectal Cancer.

 

Implementation of Community-Based Education to Promote CRC Knowledge

According to the estimates provided by WHO, in the year 2017, adults diagnosed with Colorectal Cancer (CRC) were 130,000; those who died were 50,000 (Briant et al., 2018). Among other cancers affecting adults, CRC 3rd most common in the US and the 2nd most commonly diagnosed among Hispanic adults. According to Brenner et al. (2016), the US has witnessed a gradual decline in the incidences and mortalities of CRC since the 1980s, and this is attributed to the removal of rectal polyps, increased screening rates, and behavior modification, which address potential risk factors. However, this decline is not evident in all US adults.

Existing research suggests that Hispanics are at a higher risk of CRC-related mortality and morbidity due to lower education levels, high rates of poverty, being uninsured, and not being able to access healthcare services (Jackson et al., 2016). These disparities are evident in the rates of CRC and screening rates. To address this issue, research suggests that health education programs to improve screening and create awareness are the most effective approach for prevention and improved health outcomes. This paper examines the background information and significance of CRC screening and CRC knowledge among Hispanics. Using the PICO process, a PICO question is formulated to facilitate clinical inquiry to improve knowledge on CRC and screening rates among Hispanics.Implementation of Community Education for the Prevention of Colorectal Cancer.

Background

In the United States, CRC affects close to 5% of the general population. For instance, in the year 2016, there were up to 135,000 new cases (Briant et al., 2018). Besides, it is notably the primary cause of mortalities among Hispanics in the US, where every three Hispanic women and men are diagnosed in the life course. Among deaths secondary to cancers, it is the 2nd and the third that causes mortalities among adults of Hispanic origin (Barzi et al., 2017).  Hispanics make up 85% of the population where our facility is located and have high mortality and incidence rates compared to whites, who comprise 13% of the population.Implementation of Community Education for the Prevention of Colorectal Cancer.

Screening for CRC is vital for early detection and diagnosis since it also increases the survival rates. Although Hispanics are less likely to undergo screening for CRC, it is necessary to identify reasons that lead to very low screening rates in this population. According to a 2017 report by the ACS (American Cancer Society), mortality is reducing at a slower rate among Hispanics in comparison to Blacks and Whites (Barzi et al., 2017). Diagnosis in the late stages and lower screening rates are significant contributors to disparities in mortality.

According to the USPSTF, other ethnicities strictly observe the screening recommendations for CRC. In comparison to Asians, Whites, and African Americans, CRC screening rates increased the least among Hispanics. For instance, between the years 2005 and 2013, among adults aged 50-75 years old, the screening rates for whites increased from 41-60%, blacks 35-58%, and Asians 27-50%. However, for Hispanics, the rates only increased from 27-41% (Jackson et al., 2016). Besides, there are also disparities in screening between urban and rural dwellers, with Hispanics having the least prevalence of CRC screening at 28%. Among African Americans and Whites, the screening prevalence was 35% and 39%, respectively. These rates are lower when compared to population s residing in urban regions whose screening prevalence were: Whites (45%), Blacks (42%), and Hispanics (30%).

In our healthcare facility, CRC is the most prevalent diagnosed cancer that causes morbidity and mortality among Hispanics, and the majority are diagnosed in the late stages. However, diagnosis in the advanced stages hinders the effectiveness of treatment. The facility has also witnessed high mortality rates among Hispanics living in rural areas. As supported by Ladabaum et al. (2015), this indicates an inability to access PCP and follow-up for abnormal findings. It is inarguable that for Hispanic’s rural dwellers, the hurdles for rural dwelling and being an ethnic minority worsens the situation.Implementation of Community Education for the Prevention of Colorectal Cancer.

CRC is treatable and preventable. However, in the advanced form, its prognosis is very poor. Therefore, early diagnosis and detection increase treatment success and survival outcomes. Underutilization of screening plays a significant role in staging and diagnosis of CRC, where the unscreened are at a higher risk of diagnosis in the advanced stages (Martinsen et al., 2016). Similar to the inequity rates of CRC, disparities in the rates of CRC screening and adherence to screening guidelines contribute to high incidences of CRC among Hispanics. This has been attributed to geography, ethnicity, and socioeconomic status. As supported by Shokar et al. (2015), there are more barriers for rural-dwelling Hispanics, such as long-distance traveling in search of care, inability to access PCPs and specialists, uninsured people. Those with a lower income and lower education levels will rarely follow the screening guidelines for CRC.Implementation of Community Education for the Prevention of Colorectal Cancer.

Significance

Present guidelines for 2020 Healthy People on adult percentage for individuals aged 50-75 years reveals that people who received screening for CRC is 70%. The national survey data indicates that the US is currently at 62 % ( Briant et al., 2018). However, when this data is systematically analyzed by ethnicity/race, the disparities become so evident. Hispanic adult men and women (48.5%) rarely go for CRC screening in comparison to whites (63%) and Black  Americans (60.5%). The rates are much lower among Spanish-speaking Hispanics (30.5%) and uninsured Hispanics (11%) (Bryant et al., 2018). Similarly, based on our facility’s statistics, there exist disparities in the incidence and mortality rates of CRC among ethnic and racial minority groups. CRC-related mortality and morbidity are even worse among ethnic and racial minority groups living in rural areas, more so Hispanics. Implementation of Community Education for the Prevention of Colorectal Cancer.

CRC is a significant cause of mortality among Hispanics in the US. It accounts for 22% of deaths among Hispanics who suffer a high burden of cancer compared to other ethnic minority groups. Research shows that a diagnosis of CRC among Hispanics has implications for patients, families, and the nation. According to the National Cancer Institute, the approximate direct medical and mortality costs and indirect morbidity costs of cancer in 2016 were more than $260 billion, and CRC constitutes more than 10% of this burden (Wittich et al., 2019). As more Hispanics get diagnosed in late stages and require more expensive treatment, it is expected that these costs will continue to increase. Evidence also suggests that the patient costs of treating CRC in a lifetime exceed $4,500. Today, apart from direct medical costs, these costs include travel and out-of-pocket expenses and time.

Other costs for Hispanic CRC patients and their families are emotional costs. Families and patients are at high risk of suffering from depression, anger, or anxiety. The complex nature of both conditions results in a very poor prognosis. Combining the financial and emotional costs reduces income for most patients already with a poor social-economic status. This has wide-ranging consequences, including an inability to meet financial commitments, reducing general spending in a household, and reduced income.Implementation of Community Education for the Prevention of Colorectal Cancer.

PICO Question

PICO is an evidence-based model for clinical inquiry. The PICO framework is used to frame and answer a clinical question and develop strategies to search for literature. The acronym stands for P-population/problem, I-chosen intervention, C-comparison, O-expected outcome. In this context, the PICO discusses as follows:Implementation of Community Education for the Prevention of Colorectal Cancer.

Population

Among adult Hispanics, CRC is the 2nd most frequently diagnosed cancer. Among Hispanic women, it is the 3rd major cause of death and 2nd among men of Hispanic origin. Hispanics are at high risk of a CRC diagnosis in the late stages, and this has a poor prognosis. The high mortality and incidence rates are attributed to their poor socioeconomic status, low education levels, lack of access to healthcare services, specialists, and PCPs.Implementation of Community Education for the Prevention of Colorectal Cancer.

Intervention

Increasing knowledge, awareness, and screening of CRC are opportunities that improve population health outcomes. As suggested by Bryant et al., (2018), this can be done through social engagement where individuals are advised to take part in CRC screening by friends and family to inspire CRC behaviors among Hispanic rural or urban dwellers. Previous interventions proved effective in increasing screening for CRC among Hispanics. Nevertheless, since the majority of the interventions were affected in PC settings, the majority of the underserved Hispanics who lacked access to care and those who were uninsured miss out. In this context, education will be implemented in a community setting. Community educators will educate and inspire individuals from the Hispanic population to go for screening using culturally appropriate education materials.

Comparison

The comparison is not providing community-based education

Outcome

Hispanics are less likely to undergo screening and seek care when CRC is in the late stages. The intended outcome is to increase the rates of CRC screening, and knowledge on CRC, which will ultimately improve survival rates and impact health disparities.

PICO Question

In the Hispanic community (P), what is the effect of the implementation of Community-based education (I) to promote CRC knowledge and screening rates (O) compared to no intervention (C)?Implementation of Community Education for the Prevention of Colorectal Cancer.

Population	Hispanic community
Intervention	Community-based intervention
Comparison	No community-based intervention
Outcome	Promote CRC knowledge and screening rates

 

Conclusion

Colorectal cancer is undeniably an issue of public health significance in the US among Hispanics. The rates of screening are generally increasing apart from rural dwelling Hispanics who show a different trend. Potential barriers for the existing disparities in the incidence and mortality rates and screening among Hispanics are poverty, lack of access to specialists and Primary Care Providers, uninsured, lack of access to health facilities, among others. Research supports community-based education to advance Hispanics’ knowledge on CRC, awareness, and screening. This intervention promotes healthy seeking behavior and improves survival rates.Implementation of Community Education for the Prevention of Colorectal Cancer.

Doctor of Nursing Practice roles also play a vital role in implementing, facilitating, and leading educational efforts to promote a healthy lifestyle and advocate for cancer prevention, specifically relating to colorectal cancer. Thus, it is crucial to educate our communities in increasing colorectal cancer knowledge and screening rates.Implementation of Community Education for the Prevention of Colorectal Cancer.